Scrub typhus is an infectious disease caused by Orientia tsutsugamushi. It is transmitted through bite of chigger mite larvae and presents with symptoms such as fever, myalgia, headache, rash, and a characteristic eschar at the site of mite bites. This report details the case of a woman exhibiting acute febrile illness, bilateral pneumonia, and severe hypoxemia, prompting suspicion of scrub typhus due to the presence of a typical eschar on the pubic mound. The patient underwent combined therapy with azithromycin and doxycycline, alongside supplemental oxygen and prone positioning, with continuous monitoring facilitated by Electrical Impedance Tomography (EIT). Eventually the patient's symptoms improved. This case highlights the importance of timely identification of ARDS in scrub typhus patients and the utility of EIT in monitoring disease progression.